Sir.—I am a practicing pediatrician in an inner-city hospital outpatient clinic. Recently, a 2-year-old patient presented for a routine checkup. On visual inspection of this child, I noted growth failure; microcephaly, with a prominent forehead; a flat nasal bridge; and downward slanting of her eyes. Having just read the study of Marion et al,1 I was very suspicious of human T-cell lymphotropic virus type III (HTLV-III) infection in this patient. Her medical history was suspect for intrauterine infection and was remarkable for a greater-than-average number of pediatric ailments, including one episode of pneumonia.
The patient at the time of this visit was asymptomatic. Some baseline studies were done that showed lymphopenia, a reticulonodular pattern on chest roentgenogram, and positive HTLV-III antibodies in the patient's sera.
Although this patient did not manifest full expression of HTLV-III embryopathy, she presented with a substantial number of features to prompt further investigation.
Perro M. Dysmorphism Leading to a Diagnosis of Acquired Immunodeficiency Syndrome. Am J Dis Child. 1987;141(5):474. doi:10.1001/archpedi.1987.04460050016003